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English
Oxford University Press Inc
08 November 2023
An engaging account of innovation in healthcare and why the results fall short for patients and society.

The evolution of the cell phones we carry in our pockets demonstrates that quality can increase while prices fall. Why doesn't healthcare also get better and cheaper?

In Why Not Better and Cheaper?, James B. Rebitzer and Robert S. Rebitzer offer an answer to this question. Bringing together research on incentives, social norms, and market competition, they argue that the healthcare system generates the wrong kinds of innovation. It is too easy to profit from low-value innovations and too hard to profit from innovations that reduce the costs of care. The result is a healthcare system that is profusely innovative yet remarkably ineffective in discovering ways to deliver increased value at lower cost. Why Not Better and Cheaper? sheds new light on the trajectory of innovation in healthcare, and how to point innovation in a better direction.

By:   , , ,
Imprint:   Oxford University Press Inc
Country of Publication:   United States
Dimensions:   Height: 163mm,  Width: 237mm,  Spine: 21mm
Weight:   413g
ISBN:   9780197603109
ISBN 10:   0197603106
Pages:   192
Publication Date:  
Audience:   Professional and scholarly ,  Undergraduate
Format:   Hardback
Publisher's Status:   Active
Chapter 1: Introduction and Overview Chapter 2: Economically Valuable Innovation Chapter 3: Missing Innovations Chapter 4: Shared Savings Chapter 5: Beyond Financial Incentives Chapter 6: Competition, Innovation, and Disruption Chapter 7: Dilemmas and Opportunities Appendix 1: Does Innovation Respond to Expected Profits? Appendix 2: Incentives Leading to Overlooked Innovations Outside of Healthcare Acknowledgments References Index

James B. Rebitzer is the Peter and Deborah Wexler Professor of Management at Boston University's Questrom School of Business where he was founding chair of the department of Markets, Public Policy, and Law. Formerly, he was the Mannix Professor of Healthcare Finance and Economics and Chair of the Economics Department at the Weatherhead School of Management at Case Western University. He is a research associate at the National Bureau of Economic Research and a research fellow at the Institute for the Study of Labor (IZA). He has received The Health Care Research Award from the National Institute of Health Care Management and the Kenneth J. Arrow Award from the International Health Economics Association. Robert S. Rebitzer is a senior advisor at Manatt Health and a Distinguished Career Institute Fellow at Stanford University. Formerly, he was a partner in the healthcare strategy practice of Accenture and a Vice President of UnitedHealth Group. He has also served as an advisor to the California Healthcare Foundation and to Stanford University's Clinical Excellence Research Center. He is currently chairman of the board of El Camino Health System.

Reviews for Why Not Better and Cheaper?: Healthcare and Innovation

The Rebitzers explore an overlooked feature of our healthcare system: it is too easy to profit from low-value innovations and too hard for cost-reducing innovations to find a buyer. The book is full of engaging examples and policy ideas. Anyone who cares about innovation in healthcare and wants to make things better should read it. * David Cutler, Otto Eckstein Professor of Applied Economics, Harvard University * In Why Not Better and Cheaper?, James and Robert Rebitzer elegantly explain the misaligned incentives in American healthcare and how to fix them. This is a must-read for anyone looking to make healthcare better and cheaper. * Bob Kocher, Partner at Venrock, and Former Special Assistant to President Obama for Healthcare and Economic Policy * The book does not disappointDLit is a masterclass in medicine, law, economics, strategy, and psychologyDLinfused with clever facts and written with a steadfast determination to make the reader smarter about taking health care, which is so doggedly frustrating and expensive, and innovating to make it better and cheaper. * Amitabh Chandra, Ethel Zimmerman Wiener Professor, Harvard Kennedy School of Government * At last, a book that explains why a country with extraordinary innovative capacity has a wildly expensive and underperforming healthcare sectorDLand it's not just the prices! The Brothers Rebitzer use fascinating examples to pinpoint the perverse incentives driving low-value innovation in the U.S. healthcare sector and to show what can be done to can set them right. * Leemore Dafny, Bruce V. Rauner Professor of Business Administration, Harvard Business School * This is a most welcome and important work on U.S. healthcare. Two brothers, Jim and Bob Rebitzer, one an economist and one a business consultant, combine their unique perspectives to give us fresh and deep insights into why healthcare innovation in the U.S. is the way it is and what we can do about it. * Martin Gaynor, E.J. Barone University Professor of Economics and Public Policy, Carnegie Mellon University * The promise of innovation is to provide better technologies at lower cost. But in healthcare markets, we often observe that ideas for potential cost-reducing innovations fail to take root and never diffuse to benefit patients. In this fantastic book, Jim and Bob Rebitzer provide a compelling diagnosis of this problem and lay out a road map for how to fix it. * Heidi Williams, Charles R. Schwab Professor of Economics, Stanford University * A compelling analysis of a question that has long puzzled experts: why innovation does not reliably increase value in healthcare. Combining insights from economics with close inspection of the institutional features of the healthcare system, Why Not Better and Cheaper? shines new light on this health policy conundrum. A must-read for all who want to improve the American health system. * Meredith Rosenthal, Boyden Gray Professor of Health Economics and Policy, T. H. Chan School of Public Health, Harvard University * Why Not Better and Cheaper?, shines a light on the remarkable anomaly that, unlike any other industry, innovation and value creation are often opposites in healthcare. The Rebitzers demonstrate this in fascinating and tangible ways, pointing out that meaningful advancements often struggle to see the light of day. An essential read for anyone in healthcare. * Lisa Suennan, Venture capitalist and serial entrepreneur * In a highly readable way, the Rebitzers do a masterful job of synthesizing a vast amount of theory and practice to answer an important question: why we don't have cost reducing innovation in healthcare. The answer lies in the incentives, norms, and competitive structure of our complex, pluralistic, and highly profitable health system. They dissect the problem carefully and compellingly and offer cogent policy suggestions about how to get more healthcare and health for the money we spend. But even these innovations may not be enough to alter the course of a multi trillion dollar 'Pimp My Ride' health system. * Ian Morrison, Author, Consultant, Futurist * Jim and Bob Rebitzer present a compelling analysis about the sources of dysfunction in the American healthcare system. They combine a broad understanding of economics with deep knowledge of healthcare to explain why important innovations often have trouble spreading widely, while marginal ones can proliferate at ruinous prices. And their recommendations, involving incentives, creative application of professional norms, and thoughtfully-regulated competition, offer a useful and optimistic path forward. * Mark Smith, M.D., Founding President and CEO of the California Healthcare Foundation *


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